Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 6 Articles
Traumatic testis dislocation is an uncommon condition and usually occurs after direct impact on the scrotum. We present an\nuncommon case of bilateral testicular dislocation caused by an automotive accident, which is the most frequently associated cause\ndescribed in literature today. Although the fact that diagnosis can be made either by physical examination or with the use of basic\nexams such as Doppler ultrasound, it is not uncommon for cases to go undetected and diagnosed late. In this case, there was a\nlate diagnosis, almost one year after the motorcycle accident. Despite this, studies describe preservation of spermatogenesis even\nafter delayed surgical correction. The treatment can be made by manual reduction, but most of the cases need surgical correction.\nTherefore, it is always necessary to performthe complete physical examination of the polytrauma patient on the first medical exam,\nin order to avoid the risk of fertility loss, endocrine dysfunction, and future malignancy....
Equally partitioned data are essential for prediction. However, in some important cases,\nthe data distribution is severely unbalanced. In this study, several algorithms are utilized to maximize\nthe learning accuracy when dealing with a highly unbalanced dataset. A linguistic algorithm is\napplied to evaluate the input and output relationship, namely Fuzzy c-Means (FCM), which is\napplied as a clustering algorithm for the majority class to balance the minority class data from about\n3 million cases. Each cluster is used to train several artificial neural network (ANN) models. Different\ntechniques are applied to generate an ensemble genetic fuzzy neuro model (EGFNM) in order to\nselect the models. The first ensemble technique, the intra-cluster EGFNM, works by evaluating\nthe best combination from all the models generated by each cluster. Another ensemble technique\nis the inter-cluster model EGFNM, which is based on selecting the best model from each cluster.\nThe accuracy of these techniques is evaluated using the receiver operating characteristic (ROC)\nvia its area under the curve (AUC). Results show that the AUC of the unbalanced data is 0.67974.\nThe random cluster and best ANN single model have AUCs of 0.7177 and 0.72806, respectively.\nFor the ensemble evaluations, the intra-cluster and the inter-cluster EGFNMs produce 0.7293 and\n0.73038, respectively. In conclusion, this study achieved improved results by performing the EGFNM\nmethod compared with the unbalanced training. This study concludes that selecting several best\nmodels will produce a better result compared with all models combined....
Hyperbaric oxygen therapy is now an integral part of the current therapeutic\narsenal, it is a treatment that has a large number of indications and which\nconcerns several specialties. This development aims to summarize some main\nindications....
Objectives: The present study analyzed in-hospital first-time stroke mortality in\nsouthwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality\nrate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based\nfollow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over\none-year period (January through December 2016) were included in the study. Data about personal\ncharacteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital\ncomplications and survival status were collected. The last reported Aseer region population was\nused to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios\n(HR) and concomitant 95% confidence intervals (95% CI) were computed using multivariate Cox\nregression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted.\nResults: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall\ncase fatality rate (CFR) of 9.7%. Non-significant difference with gender and age were observed in\nCFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed\na significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke\nsmoking (HR = 2.36), pre-stroke hypertension (HR = 1.77), post-stroke disturbed consciousness\n(HR = 6.86), poor mobility (HR = 2.60) and developing pulmonary embolism (HR = 2.63) as significant\npredictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital\nstroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could\nbe improved by smoking cessation, better control of hypertension and prevention of in hospital\ncomplication particularly pulmonary embolism....
Introduction.The objective of this study is to describe the prevalence, awareness, treatment, and control of hypertension and its associated\nrisk factors in (Central) Vietnam. Methods. In this cross-sectional study, amultistage sampling was used to select 969 participants\nfromthe general population aged from40 to 69 years.Thecardiovascular risk factorswere collected throughout the interviews\nwith a standardized questionnaire.Multivariate logistic regression analysis was conducted to test the relationship between the prevalence,\nawareness, treatment, and control of hypertension and the prevalence of risk factors. Results.The prevalence of hypertension\nwas 44.8%. It was higher in men than in women (51.3% versus 39.7%,...
An Emergency Medical Service (EMS) system must encompass a spectrum of care,\nwith dedicated pre-hospital and in-hospital medical facilities. It has to be organised in such a way as\nto include all necessary servicesââ?¬â?such as triage accurate initial assessment, prompt resuscitation,\nefficient management of emergency cases, and transport to definitive care. The global economic\ndownturn has had a direct effect on the health sector and poses additional threats to the healthcare\nsystem. Greece is one of the hardest-hit countries. This manuscript aims to present the structure of the\nGreek EMS system and the impact of the current economic recession on it. Nowadays, primary care\nsuffers major shortages in crucial equipment, unmet health needs, and ineffective central coordination.\nPatients are also facing economic limitations that lead to difficulties in using healthcare services.\nThe multi-factorial problem of in-hospital EMS overcrowding is also evident and has been linked\nwith potentially poorer clinical outcomes. Furthermore, the ongoing refugee crisis challenges the\nnational EMS. Adoption of a triage scale, expansion of the primary care network, and an effective\nprimaryââ?¬â??hospital continuum of care are urgently needed in Greece to provide comprehensive,\nculturally competent, and high-quality health care....
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